[Current Trends and Issues in Therapeutic Nuclear Medicine and Proposed Solutions]

Therapeutic nuclear medicine is an approach to treating malignant tumors by irradiating the target tissue from within. It shows comprehensive efficacy for all lesions including metastatic foci, and it is generally less toxic than chemotherapy. It is already widely utilized in the United States and Europe, where advanced research has yielded abundant evidence on novel radioisotope drugs for cancers, such as thyroid cancer, prostate cancer, breast cancer, and renal cancer. In Japan, however, there is no avoiding the fact that the development of radioisotope drugs and laying the foundation for their use lag far behind the United States and Europe. In this article, we first discuss the current trends in therapeutic nuclear medicine in and outside Japan. We then present the issues associated with their clinical application in Japan and propose solutions to those issues. Japan is expected to see an increase in the number of patients in whom therapeutic nuclear medicine is indicated in the coming years. Therefore, we need to start laying the foundation for its use immediately by tackling key issues, including optimization of radiation-related legal restraints, uniform accessibility/consolidation of radiotherapy wards, optimization of remuneration for medical services, and domestic production of radioisotopes for medical application.